The main problems which afflict the gall-bladder are an inflammatory condition known as cholecystitis and gallstones. The inflammatory condition often leads to cholelithiasis or gall-stones which are usually caused by disturbances in the combination of the bile. A change in the ratio of cholesterol and bile salts may result in the formation of deposits.

The gall-bladder is a pear-shaped organ, ten cm. long and three to five cm. wide. It lies on the under-surface of the liver on the right side just under the lower margin of the ribs. The function of the gall-bladder is to store and concentrate the bile secreted by the liver and to deliver it into the duodenum at appropriate times to assist in the process of digestion. Bile is an excretion composed mainly of bile salts and acids, colour pigments and cholesterol. Bile assists in the digestion and absorption of fats and the absorption of fat-soluble vitamins A, D, E and K, minerals and calcium.

The gall-bladder is usually full and relaxed between meals. During the process of digestion, when food reaches the duodenum, a hormone called cholecystokinin begins to be produced in the internal mucosa. When this hormone reaches the gall - bladder through the blood stream, it causes the gall-bladder to contract, thereby releasing the bile concentrate into the duodenum via a common duct.

At the start, gall-stones may be in the form of fine gravel. But these fine particles constitute the nucleus for further deposits, ultimately leading to the formation of larger stones. The incidence of gall-stones is five times higher in females than in males, particularly in the obese and over 40 years of age.

Symptoms

The major symptom of gall-bladder disease is acute or intermittent epigastric pain. Indigestion , gas, a feeling of fullness after meals, constipation, nausea and disturbed vision are the other usual symptoms. Intolerance to fats, dizziness, jaundice, anaemia, acne and other lesions may also occur. Varicose veins, haemorrhoids and break-down of capillaries are also disorders associated with gall-bladder troubles.

Causes

The association of gall-bladder disease with obesity together with their reported rarity in primitive people, living on simple diets, suggest that dietary factors play a major role in the development of this disease. The main causes of gall-bladder disorders is overnutrition caused by refined carbohydrates, especially sugar as the loss of fibre removes a natural barrier to energy intake. Over- nutrition also leads to increased cholesterol secretion.

Meals rich in fats may cause an attack of gall-bladder pain or gall-stone colic. Chronic constipation is a most important predisposing factor. Poor health, hereditary factors, stress, spinal displacements, bad posture and muscular tension may also cause gall-bladder disorders. The Chinese link the gall-bladder disorders with the emotion of anger.

Types of gall-stones

There are three types of gall-stones, depending on the cause of their formation. These are : cholesterol stones, caused by the change in the ratio of cholesterol to bile salts ; pigment stones, composed of bile pigment and caused by the destruction of red blood cells due to certain blood disease, and mixed stones consisting of layers of cholesterol, calcium and bile pigment resulting from stagnation of the bile flow. The third type is by far the most common.

Dietetic Cure

Surgery becomes necessary if the gall-stones are very large or in cases in which they have been present for long. Smaller gall-stones, can, however, be cleared through dietetic cure. In cases of acute gall-bladder inflammation, the patient should fast for two or three days, until the acute condition is cleared. Nothing but water should be taken during the fast. After the fast, the patient should take fruit and vegetable juices for few days. The juice of carrots, beets, grape-fruits, pears, lemons or grapes may be used.

After the juices, the patient should adopt a well- balanced diet which should contain an adequate amount of all the essential nutrients. Ideally, the diet should be lacto-vegetarian, with emphasis on raw and cooked vegetables, fruit and vegetables juices, and a moderate amount of fruits and seeds. Pears should be eaten generously as they have a specific healing effect on gall-bladder. Yogurt, cottage cheese and a tablespoon of olive oil twice a day should also be included in the diet. Oil serves as a stimulant for the production of bile and lipase, the fat digesting enzymes. High quality vegetable oil in the diet also prevents gall-stone formation.

The patient should eat frequent small meals rather than three large meals. The following is the suggested menu for those suffering from gall-bladder disorders :

Upon arising : A glass of lukewarm water mixed with lemon juice and honey or fresh fruit juice.

Breakfast : Fresh fruit, one or two slices of whole meals toast and a cup of skimmed powder milk.

Mid-morning : Fresh fruit juice.

Lunch : Vegetable soup, a large salad consisting of vegetables in season with dressing of lemon or vegetable oil. Fresh fruit for dessert, if desired.

Dinner : Vegetable juice, one or two lightly cooked vegetables, baked potato, brown or unpolished rice or whole wheat chappatis and a glass of butter-milk.

Oil cure has been advocated by some nature cure practitioners for the removal of gall-stones. Raw, natural, unrefined vegetable oils for example, olive or sunflower oil are used. The procedure is to take one ounce of vegetable oil, preferably olive oil, first thing in the morning and follow it immediately with four ounces of grapefruit juice or lemon juice. This treatment should be taken each morning for several days, even weeks, if necessary.

The pain of gall-stone colic can be relieved by the application of hot packs or fomentation to the upper abdominal area. A warm water enema at body temperature will help eliminate faecal accumulations if the patient is constipated. Exercise is also essential.